Análise da cobertura da triagem auditiva neonatal no Nordeste brasileiro

Abstract

Introduction: Universal Neonatal Hearing Screening (UNHS) is the recommended screening test for hearing loss diagnosis. Purpose: To perform a spatial analysis of the coverage of the Neonatal Hearing Screening (NHS) in the Northeastern of Brazil and to verify the possible association of the coverage with the number of Speech-Language Pathology and Audiology (SLPA) maternities and reference centers in hearing health. Methods: The reference population was of live newborns registered in the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos -SINASC). For the data collection, electronic banks were set up in the Health Information Systems. Exploratory spatial analysis was performed using TabWin software; Descriptive statistical analysis: absolute and relative distribution and weighted mean calculation; Analytical, using Chi-square and Fisher's Exact tests, in which a significance level of 0.05 was adopted. Results: There was similarity throughout the Northeastern, regarding the low coverage of the NHS. The highest indices were concentrated in specific areas and there was a homogenous distribution among states. However, the states of Piauí and Paraíba stand out as to the frequency of coverage in municipalities with the NHS service. It was found an association between the coverage and the number of maternities, Speech-Language Pathology and Audiology and centers of reference in hearing health. Conclusion:The low coverage of the triage prevails throughout the Northeastern, and the best coverages are found in peculiar areas, where the large population centers are located. There was association with the lack of Speech-Language Pathology and Audiology enrolled in the Unified Health System, centers of reference in hearing health and the number of maternities.

Neonatal hearing screening programs: quality indicators and access to health services

“…Access to the Child Hearing Health Care Network presents obstacles with an evasion above expectations and children with late ages in the stages of diagnosis and intervention in developing countries, 4,6,28 in addition, in Brazil, there are regional differences regarding the offer of services and specialized professionals, directly impacting access. 8,15,16,24 On the other hand, developed countries have better indicators regarding access to hearing health services, 4 such as the United States, which has universal coverage of screening and ages of diagnosis and intervention of around 2 and 3 months, respectively. 29 In the present study, the organization of the Hearing Health Care Network can be observed in the universality indicator and in the regulation of children for specialized care.…”

“…7 A more recent study found a weighted average of municipalities covered by the NHS of only 45.9% in 2017. 8 Global hearing health indicates obstacles that impede to achieve the quality indicators for a good program, such as the distance from the residence to the service, the parents' socioeconomic conditions and the evasion of families. The low supply of qualified professionals and specialized services interfere with access to hearing health services, directly impacting the intervention of children with hearing loss.…”

Acesso ao serviço de saúde auditiva infantil no Rio Grande do Norte, Brasil

“…12,303/2010, all children must undergo screening 4 , which was not found in the program studied. In the Northeast region of Brazil, the low percentage of coverage of neonatal hearing screening was associated with insufficient speech therapists inserted in the SUS and the hearing health services 16 . Considering that the organization of the Network depends on the diagnosis and analysis of the health situation5, commonly carried out by the speech therapist, the lack of this professional in the network certainly hinders access and breaks the continuity of care.…”

Caderneta De Saúde Da Criança: Coordenação Do Cuidado E Acesso À Saúde

“…A ausência do registro poderia ser interpretada como não realização dos exames de triagem neonatal por falta de equipe, conforme resultado no Nordeste do Brasil (18) , por distribuição desigual desses profissionais entre regiões (19) ou até mesmo por subutilização dessa tecnologia de rastreamento (20) . Contrário a essas evidências, ressalta-se que as maternidades públicas do município estudado dispõem de profissionais de saúde para a efetivação das triagens ao nascimento.…”